Tuberculosis (TB) remains one of the most prevalent and lethal infections worldwide. According to the World Health Organization’s 2022 data, over 10 mn individuals will contract tuberculosis, leading to 1.3 mn fatalities. If the current prevention and treatment strategies persist, by 2030, an additional 43 mn individuals could contract tuberculosis, resulting in 6.6 mn deaths. The impact of TB is particularly pronounced in Central Asia due to medical limitations. While TB is virtually eradicated in wealthier nations, it continues to afflict the poorest regions.
Kyrgyzstan has the highest infection rate per 100,000 people in Central Asia. Conversely, Turkmenistan has the lowest number of infections but the highest mortality rate, with approximately 26% of infected individuals succumbing to the disease. Kazakhstan has the lowest mortality rate at 3%, while Uzbekistan occupies a middle position with an 11% mortality rate.
Kazakhstan
Kazakhstan has recently witnessed a decline in TB incidence, prevalence, and mortality. In 2023, the country registered 6,899 new TB cases. The state fully funds TB prevention, diagnosis, and treatment, allocating $92mn from the national budget in 2023.
The Global Fund to Fight AIDS, Tuberculosis, and Malaria supported Kazakhstan through various grant programs, contributing over $107.2mn over the past 15 years. An additional $6.8mn is planned for project financing until 2025.
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The Stop TB Partnership, a UN-affiliated organization, has been active in Kazakhstan since 2001. As part of the Copenhagen Consensus Center project, additional funding is provided by governments, and international, and philanthropic organizations in the fight against TB.
In 2022, Kazakhstan had one of the highest TB diagnosis rates, detecting an average of 66% of cases, second only to Turkmenistan with 81%.
Kyrgyzstan
Kyrgyzstan has the highest TB incidence rates per 100,000 population among Central Asian countries. Until 2020, more than 5,000 active TB cases were registered annually. However, during the coronavirus pandemic, the figures fell by almost 1.5 times, a trend noted globally by the WHO.
Recently, the country has seen a significant increase in incidence among adults and children. The UNDP initiative “Effective Control of HIV and TB”, implemented jointly with the public organization “Ulukman Daryger”, is a key project to combat TB. In 2022, this initiative screened over 700 individuals, identifying 8 new TB cases.
In early 2023, the non-governmental organization “Ulukman Daryger” launched a project in Karakol for the prevention and treatment of tuberculosis among key population groups. The project, with a total budget of $27mn, aims to actively identify tuberculosis among contact persons and the general population and is set to run from 2021 to 2023.
The US Agency for International Development (USAID) is aiding Kyrgyzstan’s medical institutions in enhancing the diagnosis and treatment of this infectious disease. In 2023, as part of the “Support for Patients with Tuberculosis” project, family medicine centres in Bishkek received X-ray viewing equipment and treatment monitoring tools worth 1.2mn soms ($13,470) to modernize anti-tuberculosis care.
A significant step in preventing this disease was the international accreditation (ISO 15189) of the country’s first tuberculosis laboratory, made possible with the support of the USAID “Cure Tuberculosis” program.
Despite financial and other challenges, a comprehensive range of measures is being implemented in Kyrgyzstan, with the support of international organizations, to prevent, detect, and treat this dangerous infectious disease.
Turkmenistan
Turkmenistan’s Ministry of Foreign Affairs has reported successful collaboration with the World Health Organization (WHO) to end the global tuberculosis epidemic by 2035. According to WHO, Turkmenistan had 48 cases of tuberculosis per 100,000 population in 2022, down from 88 in 2014. This is the best indicator among the five Central Asian countries.
Turkmenistan is a high-priority country in the fight against tuberculosis in the WHO European Region. The Republic has adopted the National Program for the Prevention and Control of Tuberculosis until 2025. Its main goal is to reduce the disease burden in the country by ensuring universal access to timely and high-quality diagnosis and treatment of all forms of tuberculosis.
Despite these efforts, Turkmenistan still has the highest mortality rate from the disease. The country is implementing joint projects with the Global Fund to Fight AIDS, Tuberculosis and Malaria, WHO, the United Nations Development Program (UNDP), USAID, and others. In 2022, the Global Fund announced the possibility of Turkmenistan receiving another grant to combat tuberculosis, amounting to $6mn for the period 2025-2027.
In September 2023, the UNDP office in Turkmenistan noted that the authorities were doing substantial work to transition to full state funding of anti-tuberculosis programs.
Uzbekistan
Tuberculosis continues to place a significant burden on Uzbekistan’s healthcare system. According to Lianne Kuppens, the head of the WHO office in Uzbekistan, although the WHO European Region (53 countries, including Uzbekistan) accounts for only 3% of the total number of TB cases in the world, it has one of the highest proportions of multidrug-resistant tuberculosis.
In the republic, a specific law titled “On protecting the population from tuberculosis” is in place to tackle tuberculosis. This law mandates the protection of the populace from the disease through preventive actions, medical screenings, and treatment of tuberculosis in specialized institutions. The country also enforces compulsory vaccination for newborns and revaccination for children.
USAID is a key organization assisting the republic in its battle against tuberculosis. In 2021, USAID facilitated the delivery of two WHO-prequalified (WHO-PQ) tuberculosis treatment drugs - cycloserine and prothionamide - to Uzbekistan.
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